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For years, women have been told that fertility usually starts declining after the age of 35. But today, many couples are finding it difficult to conceive much earlier than that. Fertility experts are increasingly seeing women in their late 20s and early 30s seeking medical help after months of unsuccessful attempts to get pregnant. So, what has changed?
According to Dr Hetal Parekh, Senior Consultant, Vitro Fertilization, fertility is influenced by much more than age alone. Lifestyle habits, hormonal disorders, environmental pollutants, and even male fertility issues are playing a growing role. Understanding these factors early can help couples seek timely treatment and improve their chances of a healthy pregnancy.
Compared to previous generations, many women today choose to postpone pregnancy while pursuing higher education, building careers, or achieving financial stability. Although these are important personal choices, female fertility naturally declines with age because both the number and quality of eggs gradually decrease.
According to Dr Parekh, some studies suggest that Indian women may experience a decline in ovarian reserve at a slightly younger age, highlighting the importance of timely fertility assessment for those planning a pregnancy.
Being overweight can interfere with hormone balance, ovulation, and egg quality. Insulin resistance, which is common in women with obesity and polycystic ovary syndrome (PCOS) (now known as PMOS—polyendocrine metabolic ovarian syndrome), can make it harder to conceive naturally.
Fertility problems are not limited to obesity. Strict dieting, excessive exercise, and being underweight can disrupt ovulation and lead to irregular or absent menstrual cycles, making conception more difficult.
Modern lifestyles often involve long work hours, shift duties, sedentary routines, and chronic stress. According to Dr Parekh, ongoing stress and poor-quality sleep can affect hormone regulation and reproductive health, reducing fertility over time.
Smoking, alcohol consumption, and tobacco use have become more common among younger women. These habits can damage egg quality, reduce ovarian reserve, and increase the risk of infertility.
Daily exposure to air pollution, pesticides, BPA, phthalates, and microplastics is becoming a growing concern. Research suggests these endocrine-disrupting chemicals may interfere with hormone function and negatively impact fertility.
India has a high prevalence of PCOS, a hormonal disorder that often causes irregular ovulation. Without regular egg release, conception becomes more difficult, making PMOS one of the most common reasons for infertility in young women.
Endometriosis occurs when tissue similar to the lining of the uterus grows outside it, causing pain and inflammation. It can damage the reproductive organs and significantly reduce fertility if left untreated.
Conditions such as pelvic inflammatory disease (PID) and genital tuberculosis continue to be important causes of infertility in the Indian subcontinent. Early diagnosis and treatment can help reduce long-term reproductive damage.
Thyroid disorders, autoimmune diseases, and other metabolic conditions can interfere with ovulation, implantation, and overall reproductive health. Managing these conditions is an important part of fertility care.
Infertility isn’t only a women’s health issue. Studies have reported a global decline in sperm count and sperm motility, making male infertility an increasingly common contributor to delayed conception. In many cases, evaluating both partners helps identify the underlying cause more quickly.
According to the World Health Organization (WHO), infertility affects millions of people worldwide, highlighting the need for timely diagnosis and treatment. If you are under 35 and have been trying to conceive for a year without success or for six months if you are over 35, it is important to consult a fertility specialist. As Dr Parekh explains, identifying the cause early allows couples to explore appropriate treatment options and improve their chances of a successful pregnancy.
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